Laparoscopic excision of a case of percutaneous cystohepatic fistula in a patient affected by polycystic disease of the liver: point of technique.
A 76-year-old man affected by autosomal-dominant polycystic kidney disease was admitted for a 2-year history of purulent leakage from a cutaneous orifice present in the right hypochondrium. The patient was submitted to a percutaneous aspiration of a big symptomatic cyst in the right liver about 3 years earlier in another hospital. Shortly, an orifice with purulent leakage appeared in his hypochondrium. Two years later, the patient came under our observation. Computed tomography scan showed a polycystic liver with a fistula from a hepatic cyst to the skin. A laparoscopic approach was chosen to dissect the fistulous tract from its liver bed and then a cutaneous incision was performed to resect the en-block fistulous tract and skin containing the cutaneous orifice. Cystocutaneous fistula, as in our patient, is not reported yet; the laparoscopic approach allows treatment in the presence of a fistula and, as in our case, of hepatic cysts.
Di Carlo
Isidoro
I
Department of Surgical Sciences, Organs Transplantation and Advanced Technologies, University of Catania, Catania, Italy. idicarlo@unict.it
Di Stefano
Andrea
A
Pulvirenti
Elia
E
Toro
Adriana
A
D034861:Abdominal Wall; D000368:Aged; D017577:Cutaneous Fistula / Q000150:complications / Q000601:surgery*; D003560:Cysts / Q000150:complications / Q000601:surgery*; D005402:Fistula / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008107:Liver Diseases / Q000150:complications / Q000601:surgery*; D008297:Male; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications